目的:探讨评估临床指标和多期动态增强CT (Contrast-enhanced computed tomography, CECT)的影像学特征,并构建回归模型预测术前肝细胞癌(Hepatocellular carcinoma, HCC)微血管侵犯(Microvascular invasion, MVI)状态。方法:回顾性研究...目的:探讨评估临床指标和多期动态增强CT (Contrast-enhanced computed tomography, CECT)的影像学特征,并构建回归模型预测术前肝细胞癌(Hepatocellular carcinoma, HCC)微血管侵犯(Microvascular invasion, MVI)状态。方法:回顾性研究141例HCC患者的临床、影像学和病理资料。根据是否存在微血管侵犯,分为MVI阳性组77例,MVI阴性组64例。用单因素和多因素Logistic回归分析筛选MVI的独立危险因素,构建回归模型预测MVI,使用Area under the curve (AUC值)、特异度和灵敏度评估模型的预测效能。结果:最终筛选出MVI的临床和影像学独立危险因素为甲胎蛋白(Alpha-fetoprotein, AFP) ≥ 400 ng/ml、瘤周低密度环和肝外生长。结合这三个因素构建的模型ROC曲线下面积(Area under the curve, AUC)值为0.730,特异度为0.625,灵敏度为0.727。结论:由AFP联合影像学特征(瘤周低密度环和生长方式)建立的回归模型可以在一定程度上预测术前MVI状态,有助于临床优化治疗策略。Objective: To investigate the role of clinical indicators and imaging characteristics from multiphase contrast-enhanced computed tomography (CECT) in predicting preoperative microvascular invasion (MVI) in hepatocellular carcinoma (HCC), and to construct a predictive regression model for microvascular invasion (MVI) status. Methods: Clinical, imaging, and pathological data of 141 patients with HCC were studied retrospectively. Based on the presence or absence of microvascular invasion, patients were divided into MVI-positive group (n = 77) and MVI-negative group (n = 64). Independent risk factors for MVI were screened using univariate and multivariate Logistic regression analyses, and a regression model was constructed to predict MVI, and the predictive efficacy of the model was assessed using the Area under the curve (AUC value), specificity and sensitivity. Results: Independent risk factors for MVI identified from both clinical and imaging data included AFP ≥ 400 ng/ml, peritumoral hypodense halo, and extrahepatic growth. The area under the ROC curve (AUC) value of the model combining these three factors was 0.730, the specificity was 0.625 and the sensitivity was 0.727. Conclusion: The regression model incorporating AFP levels and key imaging features (peritumoral hypodense halo and extrahepatic growth) demonstrates moderate predictive value for preoperative MVI status, which may assist in optimizing clinical treatment strategies for patients with HCC.展开更多
探讨CT扫描与MRI成像在腰椎间盘突出症诊疗中的有效性,并对其成像特点进行详尽分析。研究纳入2023年6月至2024年6月间在本院接受治疗的92名腰椎间盘突出症患者,并通过随机分配方式将其划分为CT检查组(共46人)与MRI检查组(共46人)。其中...探讨CT扫描与MRI成像在腰椎间盘突出症诊疗中的有效性,并对其成像特点进行详尽分析。研究纳入2023年6月至2024年6月间在本院接受治疗的92名腰椎间盘突出症患者,并通过随机分配方式将其划分为CT检查组(共46人)与MRI检查组(共46人)。其中,CT检查组接受了64层螺旋CT的扫描,而MRI检查组则进行了1.5特斯拉的磁共振成像检查。本研究对两组患者在诊断准确性、灵敏度、特异性以及影像特征呈现方面的数据进行对比分析。结果 MRI组在诊断准确率(95.65% vs 86.96%,P<0.05)、敏感度(97.67% vs 88.37%,P<0.05)和特异度(93.75% vs 85.71%,P<0.05)方面均高于CT组。MRI对软组织对比分辨率更高,能更清晰显示椎间盘退变、神经根受压等特征(P<0.05)。CT在显示骨质增生、钙化等方面优于MRI(P<0.05)。结论 MRI在诊断腰椎间盘突出症方面整体效能优于CT,但两种检查方法各有优势,临床上应合理选择和结合使用。展开更多
目的:探讨动态对比增强磁共振(dynamic contrast-enhanced magnetic resonance,DCE-MR)图像根据乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)规范的影像特征对乳腺癌分子分型的预测价值。方法:回顾性分...目的:探讨动态对比增强磁共振(dynamic contrast-enhanced magnetic resonance,DCE-MR)图像根据乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)规范的影像特征对乳腺癌分子分型的预测价值。方法:回顾性分析行乳腺MRI检查的97例乳腺癌患者的临床和影像学资料,其中Luminal A型26例、Luminal B型34例、人表皮生长因子受体-2(human epidermal growth factor receptor 2,HER-2)过表达型19例、三阴性18例。比较4种不同分子亚型乳腺癌的影像学特征,采用多元Logistic回归分析影响乳腺癌分子分型的因素及其预测乳腺癌分子分型的价值。结果:不同分子亚型乳腺癌肿瘤最大径、子灶、周围血管增多及乳头改变比较,差异均有统计学意义(P<0.05)。多元Logistic回归分析结果显示,肿瘤最大径、子灶、周围血管增多及乳头改变是乳腺癌分子分型的独立影响因素(均P<0.05),四者联合预测乳腺癌分子分型准确率分别为72.0%、88.6%、84.2%、73.7%,模型总体预测准确率为80.6%。结论:肿瘤最大径、子灶、周围血管增多及乳头改变可有效预测乳腺癌分子分型。展开更多
文摘目的:探讨评估临床指标和多期动态增强CT (Contrast-enhanced computed tomography, CECT)的影像学特征,并构建回归模型预测术前肝细胞癌(Hepatocellular carcinoma, HCC)微血管侵犯(Microvascular invasion, MVI)状态。方法:回顾性研究141例HCC患者的临床、影像学和病理资料。根据是否存在微血管侵犯,分为MVI阳性组77例,MVI阴性组64例。用单因素和多因素Logistic回归分析筛选MVI的独立危险因素,构建回归模型预测MVI,使用Area under the curve (AUC值)、特异度和灵敏度评估模型的预测效能。结果:最终筛选出MVI的临床和影像学独立危险因素为甲胎蛋白(Alpha-fetoprotein, AFP) ≥ 400 ng/ml、瘤周低密度环和肝外生长。结合这三个因素构建的模型ROC曲线下面积(Area under the curve, AUC)值为0.730,特异度为0.625,灵敏度为0.727。结论:由AFP联合影像学特征(瘤周低密度环和生长方式)建立的回归模型可以在一定程度上预测术前MVI状态,有助于临床优化治疗策略。Objective: To investigate the role of clinical indicators and imaging characteristics from multiphase contrast-enhanced computed tomography (CECT) in predicting preoperative microvascular invasion (MVI) in hepatocellular carcinoma (HCC), and to construct a predictive regression model for microvascular invasion (MVI) status. Methods: Clinical, imaging, and pathological data of 141 patients with HCC were studied retrospectively. Based on the presence or absence of microvascular invasion, patients were divided into MVI-positive group (n = 77) and MVI-negative group (n = 64). Independent risk factors for MVI were screened using univariate and multivariate Logistic regression analyses, and a regression model was constructed to predict MVI, and the predictive efficacy of the model was assessed using the Area under the curve (AUC value), specificity and sensitivity. Results: Independent risk factors for MVI identified from both clinical and imaging data included AFP ≥ 400 ng/ml, peritumoral hypodense halo, and extrahepatic growth. The area under the ROC curve (AUC) value of the model combining these three factors was 0.730, the specificity was 0.625 and the sensitivity was 0.727. Conclusion: The regression model incorporating AFP levels and key imaging features (peritumoral hypodense halo and extrahepatic growth) demonstrates moderate predictive value for preoperative MVI status, which may assist in optimizing clinical treatment strategies for patients with HCC.
文摘探讨CT扫描与MRI成像在腰椎间盘突出症诊疗中的有效性,并对其成像特点进行详尽分析。研究纳入2023年6月至2024年6月间在本院接受治疗的92名腰椎间盘突出症患者,并通过随机分配方式将其划分为CT检查组(共46人)与MRI检查组(共46人)。其中,CT检查组接受了64层螺旋CT的扫描,而MRI检查组则进行了1.5特斯拉的磁共振成像检查。本研究对两组患者在诊断准确性、灵敏度、特异性以及影像特征呈现方面的数据进行对比分析。结果 MRI组在诊断准确率(95.65% vs 86.96%,P<0.05)、敏感度(97.67% vs 88.37%,P<0.05)和特异度(93.75% vs 85.71%,P<0.05)方面均高于CT组。MRI对软组织对比分辨率更高,能更清晰显示椎间盘退变、神经根受压等特征(P<0.05)。CT在显示骨质增生、钙化等方面优于MRI(P<0.05)。结论 MRI在诊断腰椎间盘突出症方面整体效能优于CT,但两种检查方法各有优势,临床上应合理选择和结合使用。
